Functional imaging with diffusion-weighted MRI for lung biopsy planning: initial experience

World Journal of Surgical Oncology

Myrna C B Godoy⁵  Rubens Chojniak⁴  Jefferson L Gross¹  Chiang C Tyng⁶  Charles E Zurstrassen⁶  Almir G V Bitencourt⁴  Bruno Hochhegger²  Bruno C Odisio⁵  Edson Marchiori³  Marcos D Guimaraes⁴ 

[1] Department of Thoracic Surgery, AC Camargo Cancer Center, Rua Paulo Orozimbo, 726, Aclimação, Zip 01535-001 São Paulo, SP, Brazil;Department of Radiology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Prof. Annes Dias, 295, Centro, Zip 90020-090 Porto Alegre, RS, Brazil;Department of Radiology, Universidade Federal do Rio de Janeiro, Rua Thomaz Cameron, 438,Valparaiso, Zip 25685-120 Petrópolis, RJ, Brazil;Department of Imaging, AC Camargo Cancer Center, Rua Paulo Orozimbo, 726, Aclimação, Zip 01535-001, São Paulo, SP, Brazil;Department of Diagnostic Radiology, MD Anderson Cancer Center, 1515 Holcombe Blvd, Zip 77030 Houston, TX, USA;Department of Interventional Radiology, AC Camargo Cancer Center, Rua Paulo Orozimbo, 726, Aclimação, Zip 01535-001 São Paulo, SP, Brazil

关键词: PET/CT-guided biopsy;    Lung lesion;    Transthoracic biopsy;    DWI;    MRI-guided biopsy;    Functional imaging;   

Others  :  1148778
DOI  :  10.1186/1477-7819-12-203

 received in 2013-12-23, accepted in 2014-06-29,  发布年份 2014

【 摘 要 】

Background

The purpose of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) and positron emission tomography/computed tomography (PET/CT) in planning transthoracic CT-guided biopsies of lung lesions.

Methods

Thirteen patients with lung lesions suspicious for malignancy underwent CT-guided biopsy. Chest DW-MRI and apparent diffusion coefficient (ADC) calculation were performed to aid biopsy planning with fused images. MRI was indicated due to large heterogeneous masses, association with lung atelectasis/consolidation/necrosis, and/or divergent results of other biopsy type and histopathology versus clinical/radiological suspicion. Eight patients underwent PET/CT to identify appropriate areas for biopsy.

Results

Mean patient (n = 9 males) age was 59 (range, 30 to 78) years. Based on DW-MRI results, biopsies targeted the most suspicious areas within lesions. All biopsied areas showed higher DW signal intensity and lower ADCs (mean, 0.79 (range, 0.54 to 1.2) × 10⁻³ mm²/s), suggesting high cellularity. In patients who underwent PET/CT, areas with higher 18-fluorodeoxyglucose concentrations (standard uptake value mean, 7.7 (range, 3.6 to 13.7)) corresponded to areas of higher DW signal intensity and lower ADCs. All biopsies yielded adequate material for histopathological diagnosis.

Conclusions

Functional imaging is useful for lung biopsy planning. DW-MRI and PET/CT increase overall performance and enable the collection of adequate material for specific diagnosis.

【 授权许可】

   
2014 Guimaraes et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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